circumcision: is it an insignificant act?

The circumcision is one of the most frequent interventions practised to a male child; it is defined as surgical removal of the prepuce for a religious or traditional reasons. The surgical removal of the prepuce, is carried out either in emergency in case of paraphimosis, or normally case of phimosis. The complications of the circumcision are frequent and varied; haemorrhage and infection are described as early complications while generaly the urological complications are known as late complications. Those are even more frequent when the circumcision is performed in a traditional way or by non professional [paramedical agents, hajjamas...] without a rigorous asepsis and in unfavourable material conditions. If the ritual circumcision is uncertain, the circumcision performed in surgical conditions remains a benign intervention

[Abdominal pains in childhood: viewpoint of the paediatric surgeon]

The abdominal pains are very frequent symptoms in pediatric pathology. concerned that is has multiple aetiologies we distinguish that the actue abdominal pains are generally of organic aetiology dominated by surgical intervention and reccurent als abdominal pains generally of functional artiology. The diagnosis of an abdominal pain above all will be determined by the most precise possible semiological anaysis [anamnesis], and by the physical examination. The place of the complementary examinations must remain limited, according to the clinical assumptions or be summarized with simple examinations of orientation. The pediatric surgeon in practice is in front of a double trap: to standardize abdominal pains which will prove to be of organic origin, or to contemplate organic cause with the risk to suggest expensive and intensive complementary examinations to the child and his family, which are likely to fix them still more on this symptom

[Primitive eosophageal achalasia in children: a 20 cases report]

The aim of this study is to evaluate the results of Heller intervention in the treatment of oesophageal achalasia in children. Method: it's a retrospective study of 20 cases of oesophageal achalasia in children during 19 years [1985-2003]. The mean age was 8 year-old. No etiological factor has been reported. Dysphagia was the main symptom [80%], regurgitations were present in 50% of cases, and respiratory troubles in 45% of cases. A body weight insufficiency was reported in 60% of cases. All the children had Heller intervention which was systematically associated to an antireflux system. After a mean follow-up of 3 years, the results were excellent in 70% of case and had confirmed the efficacy of Heller intervention in oesophageal achalasia in children

Thyroid cancer in child [about 7 cases]

We report here a study of 7 cases of thyroid cancer in childhood. This study that we reinforced by literature review aims to point out the different aspects of this affection: clinical features, the complementary examinations and the management to diagnoses it with certainty and lastly, the different therapeutical attitudes. It is a study of 7 children between 8 and 15 years aged, with a female daminance, without pearicular previous medical histories. Clinically, these children present an euthyroidal goitre, cervical adenopathies with conservation of good general health condition. Scintigraphy showed a cold nodule that was proved to be neoplastic at the anatomo-pathological study, it was papillar or papillo-vesicular carcinoma. The surgical management has at the present time a tendancy to conservative surgery combined or not with a ganglionic curage, followed by a substitute hormonal treatment. In general, the prognosis of this affection is good for the differentiated forms whereas it remains has for bad anaplastic non differentiated forms

Currarino's syndrome

Currarino's triad is a congenital malformation involving the combination of anorectal stenosis, a presacral mass and an anterior sacral bony defect. A new case is reported in a male neonate, who developed intestinal obstruction on the second day of life. The examination revealed a high anorectal malformation. A colostomy was performed. Partial agenesis of the sacrum was diagnosed radiologically. Computed tomographic myelography demonstated an anterior sacral meningocele and a tethered spinal cord. Excision of the meningocele and untethering of a tethered spinal cord were performed. Secondly, posterior sagittal anorectoplasty was performed. Colostomy was closed 3 months after rectal dilatations. Early diagnosis and management is recommended to avoid the high mortality and morbidity associated with this condition

Phlebectasie jugulaire ou ectasie veineuse jugulaire chez l'enfant

Jugular phlebectasia is a congenital dilatation in the way of jugular vein or one of its original branches. It presents generally as a depressible mass, and become replete on moments of cry or on valsavas maneuver. it may be discerned of other latero-cervical tumors as the laryngocele and lymphangioma. Echography and Doppler are perfomed for the diagnosis. Treatment consists at the excision of the ectasie segment and so avoid complications of a benign pathology

Dilatation congenitale de la voie biliaire princibale

Through a 10 cases report of congenital dilatation of the common bile duct and the review of the literature, the authors insist on the diagnostic problems of this affection, its etiology widely dominated by the common biliaro-pancr‚atic duct theory, and its therapeutic consequence that is the resection as more as possible of the biliary anomaly

Le pneumoblastome chez l'enfnt

Within the last five years, the authors were responsible for 3 lihlegirls suffering from respiratory problems which radiologic investigations had attributed a pulmonary solid mass. Each patient was treated surgically. Post operative histological study incovered a pneumoblastoma with its three characteristic cellular components. One year later, evolution was favorable in one patient; whereas the two others died rapidly in spite of a complementary anti cancerous chemotherapy

[Adrenal cortical tumor in child report of three cases]

The report of three adrenal cortical tumors cases in a period of 15 years allows to authors to study the clinical aspects of this affection, its management method, his histological characteristics and prognosis